Research suggests that appraisals of a stressful event, such as the likelihood of change and perceived ability to cope, are important predictors of the use of coping strategies and overall adaptation. This study explored the relationships between coping self-efficacy, coping strategies, and grief reaction with individuals who have undergone presymptomatic genetic testing for Huntington?s Disease (HD). Surveys were sent to 96 and 100 individuals from the Indiana University and Johns Hopkins University pre-symptomatic HD testing databases, respectively. Eligibility criteria included individuals who tested negative or positive, and who were currently without symptoms of HD. Measures included the Coping Self-Efficacy Scale, the Ways of Coping Checklist-Revised, and the Grief Experience Inventory. Views of HD and personal significance of result was assessed with Likert scales in addition to questions regarding family history and experience with affected relatives. Open-ended items addressed the experience of having a predictive genetic test. Among the 80 respondents (40.8% response rate), 62 surveys (45 negative/17 positive result) were eligible for analysis. On average, participants had known their test result for 6 years, were 45 years old, and 62.9% were female. Preliminary regression analysis revealed coping self-efficacy to be negatively associated with the use of avoidance coping (p less than 0.001), and avoidance coping to be positively associated with grief scores (p less than 0.05). Respondents showed greater use of problem-focused coping strategies compared to emotion-focused strategies (p less than 0.001). Problem-focused coping strategies were negatively associated with measures of grief (p less than 0.05), while emotion-focused coping was positively associated with grief scores (p less than 0.01). An individual?s coping self-efficacy predicts the use of particular coping strategies which in turn can predict the degree of grief experienced. Genetic Counseling interventions are proposed to maximize coping self-efficacy and effective coping strategies in light of a genetic test result for a condition that has no treatment or cure.